System and method to manage delivery healthcare to a patient

ABSTRACT

A system and method to manage delivery of healthcare via a plurality of resources to a patient is provided. The system and method track and output a signal representative of a location of at least one of a series of resources relative to a control volume associated with the patient, acquire at least one signal representative of detecting ingress or egress of at least one of the plurality of resources relative to the control volume; and output a first signal representative of one of a series of milestones as defined in a predetermined protocol in response to detecting ingress or egress of at least one of the resources relative to the control volume.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims the benefit of priority to U.S. PatentApplication No. 12/239,270, filed on Sep. 26, 2008, for “SYSTEM ANDMETHOD TO MANAGE DELIVERY HEALTHCARE TO A PATIENT”; and to ProvisionalApplication No. 60/976,582 entitled “Method To View BiometricalInformation and Dynamically Adapt Schedule and Process Interdependencieswith Clinical Process Decisioning” filed Oct. 1, 2007, each of which ishereby incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

This invention generally relates to a system for and method to managedelivery healthcare to a patient.

Infections can result in operation of hospitals or clinics or otherhealthcare environments in association with interaction of thehealthcare provider with multiple patients, deliverables, or surfacesover a time interval or at the surgical point of care. Not only caninfections be harmful to the health of the patient, but also increasecosts to treat the patient and can harm a reputation of a healthcareinstitution.

BRIEF DESCRIPTION OF THE INVENTION

The subject matter described herein provides a system and method toreduce the probability of infection rates associated with delivery ofhealthcare in a healthcare environment. The subject matter of the systemand method described herein also enhances visualization of the protocolin delivery of healthcare to the patient without unduly interrupting orinterfering with the performance of the staff delivering the healthcare.

The above-mentioned shortcomings, disadvantages and problems areaddressed by the embodiments described herein in the followingdescription.

An embodiment of a method to manage delivery of healthcare via a seriesof resources to a patient is provided. The method comprises the steps oftracking and outputting a signal representative of a location of atleast one of the plurality of resources relative to a control volumeassociated with the patient; acquiring at least one signalrepresentative of detecting ingress or egress of at least one of theseries of resources relative to the control volume; and outputting afirst signal representative of one of a plurality of milestones asdefined in a predetermined protocol in response to detecting ingress oregress of at least one of the series of resources relative to thecontrol volume.

An embodiment of a system to manage delivery of healthcare via a seriesof resources to a patient is provided. The system comprises at least onetracking system operable to generate a signal representative of alocation of at least one of the series of resources relative to acontrol volume associated with the patient, and a controller incommunication with the tracking system. The controller includes aprocessor in communication with a memory, the processor operable toexecute a plurality of program instructions stored in the memory. Theplurality of program instructions are representative of the steps ofacquiring at least one signal representative of detecting ingress oregress of at least one of the plurality of resources relative to thecontrol volume; outputting a first signal representative of one of aplurality of milestones as defined in a predetermined protocol inresponse to detecting ingress or egress of at least one of the pluralityof resources relative to the control volume.

Systems and methods of varying scope are described herein. In additionto the aspects and advantages described in this summary, further aspectsand advantages will become apparent by reference to the drawings andwith reference to the detailed description that follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a schematic block diagram of an embodiment of a system tomanage delivery of healthcare to a patient.

FIG. 2 illustrates a schematic diagram of an embodiment of a block ofmodules of program instructions to manage delivery of healthcare to thepatient.

FIG. 3 shows a flow diagram of an embodiment of a method to deliveryhealthcare to the patient with the system of FIG. 1.

FIG. 4 shows a schematic diagram of an embodiment of a dashboardillustrative of performance of the system of FIG. 1 and method of FIG.3.

DETAILED DESCRIPTION OF THE INVENTION

In the following detailed description, reference is made to theaccompanying drawings that form a part hereof, and in which is shown byway of illustration specific embodiments, which may be practiced. Theseembodiments are described in sufficient detail to enable those skilledin the art to practice the embodiments, and it is to be understood thatother embodiments may be utilized and that logical, mechanical,electrical and other changes may be made without departing from thescope of the embodiments. The following detailed description is,therefore, not to be taken in a limiting sense.

The following is generally description subject matter is described aperioperative example is presented. It can be appreciated that monitoredactivity may occur in many venues for deliver of care (e.g., home,ambulatory or inpatient settings).

FIG. 1 illustrates an embodiment of system 100 to manage resources 105in the delivery of healthcare to a patient 110. The resources 105 caninclude personnel or staff 115 (e.g., surgeon, clinician, nurse,anesthetist, technician, etc.) and medical deliverables 120 (e.g.,imaging system 125, table 130, anesthesiology system 135, heart monitorsystem 140, respiratory monitor system 150, miscellaneous items 152 suchas medications/anesthesia or contrast agents or instruments ordisposables or consumables, etc.) in the delivery of healthcare (e.g.,medical procedure) to the patient 110.

An embodiment of the imaging system 125 can include a mobileradiological X-ray system having a gantry with a mobile C-arm in supportof a radiation source and detector operable to generate a radiologicalimage of a subject (not shown). Yet, the imaging system 125 can be alsofixed to the ground with miscellaneous moving components. Although amobile radiological imagine system is shown, it should be understoodthat the type (e.g., X-ray, magnetic resonant imaging (MRI), computedtomography (CT), ultrasound, fluoroscopic, endoscopic, laparoscopic,etc.) of imaging systems 100 can vary.

The table 130 can be located for the surgeon to perform the surgicalprocedure on the subject, as well as to position the subject be imagedby the imaging system 125. The table 130 can be configured to elevate,pan, tilt, or cradle so as to position the imaged subject in a desirablefashion for imaging by the imaging system 125.

Other medical deliverables 120 can include mechanical orelectro-mechanical devices or clothing that may be employed in aconventional manner in performing a medical procedure. For example, thesurgeon attire can typically include a surgical mask 160, a cap 165,gloves 170, booties 175, protective eyewear 180, and a gown 185. Thepatient 110 can be covered with at least one drape 190 arranged with anopening for the surgical site 192 on the patient 110. The type andnumber of medical deliverables 120 can vary.

A tracking system 195 can be operable to periodically or continuouslytrack or monitor a static or change in location or position or status ofthe miscellaneous resources 105, apparatus or personnel described above,including the location of the surgeon or other staff 115 and the patient110. The embodiment of the tracking system 120 can be in communication(e.g., wireless, wired, etc.) with a controller 200. The controller 200can also connected in communication (e.g., wireless, wired, etc.) withthe imaging system 125 other medical apparatuses (e.g., anesthesiamachine, heart rate monitor, blood pressure monitor, voice recognition,clinical systems and health information systems, etc.) located in oroutside the surgical suite and employed in the deliver of healthcare tothe patient.

An embodiment of the tracking system 195 can be operable to periodicallyor continuously measure a location or position or change thereofrelative to a reference 205. An embodiment of the reference 205 caninclude a control volume 210 or a sterile zone 215 (e.g., two- orthree-dimensional space encompassing or surrounding or located over thesurgical site or other location of interest) defined for the surgicalprocedure on the patient 110. An embodiment of the tracking system 195can be operable to define the control volume 210 or the sterile zone 215located therein, and to track or detect the ingress or egress ofresources 105 to or from such. For example, assume the control volume210 or sterile zone 215 can be shaped as a rectangular box havingcorners defined by three-dimensional coordinates relative to thereference 205 (e.g., a fixed point on the table 130. Of course, the type(e.g., static or dynamic) and location of the reference 205 can vary.The control volume 210 or sterile zone 215 can be registered relative tothe fixed reference 205 prior to the delivery of healthcare to thepatient 110, and can be periodically updated during the deliveryprocedure. The number, shapes, and dimensions of the control volume 205or sterile field 215 can vary.

As shown in FIG. 1, an embodiment of the tracking system 195 employselectromagnetic technology 220 to measure the location or movement ofthe resources 105. The tracking system 195 can include an arrangement oftransmitters in electromagnetic communication with receivers to measureand output the signal representative of the identifier and the locationof the resources 105 for communication to the controller 200. It shouldbe understood that the number, type and location of the electromagnetictransmitters or receivers can vary.

The signal output from the electromagnetic technology 220 of thetracking system 195 can also include position data indicative of anorientation (e.g., an angle of rotation) or change thereof of theresources 105 relative to the reference 205 (e.g., vertical, horizontal,etc.). In an embodiment, the tracking system 195 can electromagneticallymeasure a location and orientation of the respective resources 105capable of being tracked in such a manner. Also, the tracking system 195can be configured to electromagnetically measure a position or changethereof of a movable component of the resources 105 and to output asignal representative thereof with an identifier for communication tothe controller 200.

The illustrated embodiment of the tracking system 195 can furthercomprise transmitters and receivers configured to communicate with asatellite (e.g., global positioning technology 225) so as to measure aprecise location or movement of the resources 105 or moveable componentsthereof for communication to the controller 200.

The illustrated embodiment of the tracking system 195 can furtherinclude optic technology 230 to measure the location or orientation orchange thereof of the resources (or moveable components thereon) forcommunication to the controller 200. One embodiment of the optictechnology 230 can include a pair of camera devices 235 and 240 operableto detect and generate a signal representative of an identifier and ameasured location and orientation of optical markers 245 located on theresources 105. An example of the optical markers 245 can include graphicsymbols or reflective material or patterns of unique identification ororientation (e.g., three spaced-apart graphic representations) that canbe detected and tracked with the camera devices 235 and 240. Yet, thetype of optical markers 245 can vary.

Another embodiment of the tracking system 195 can employ at least onecamera 235, 240 operable to identify the resources 105 according tooptical detecting and recognizing resources 105 according to associationof predetermined shapes, patterns, color contrasts, reflections, etc. orcombination thereof acquired and stored in the system 100, and therebyoperable to track movement of the resources 105 accordingly. Embodimentsof the orientation of multiple cameras 235, 240 can be orthogonal (onecamera looking down from ceiling and one camera looking across horizon)or in parallel relation to one another, or a combination thereof, yetthe orientation can vary. Further, although two cameras 235, 240 areshown, the number and type (e.g., video) of cameras and combinationthereof can vary.

Another embodiment of the tracking system 195 can include a radiofrequency (RF) or infrared (IR) identification system 250. The RF/IRidentification system 250 can include RFID transmitters coupled incommunication with RFID receivers to track location and movement ofresources (e.g., staff, medical deliverables, etc.) that may enter to orfrom the surgical suite. In a like manner, the RF/IR identificationsystem 250 can otherwise or also include IR technology that can beemployed independently of or in combination with the RFID technology totrack movement of tags 255 coupled to resources 105 of interest.

The tracking system 195 can further include a voice recognition system260. An embodiment of the voice recognition system 260 can be operableto record speech of the surgeon or staff 115 and to perform voicerecognition so as to translate speech to alphanumeric language in adigital or analog context for communication to the controller 200. Thevoice recognition system 260 can further be operable to parse thealphanumeric language for key words or phrases or fragments thereof forcommunication to the controller 200 for comparison to templates thatinclude keywords, phrases, or fragments thereof representative ofprotocol or steps of the medical procedure being performed on thepatient 110. The system may utilize optics, computer vision and canrequest confirmation feedback on the system's reasoning as to whatprocess step is being observed by said system. An example confirmationmay be a rule engine providing text to a speech generator asking thesurgeon if s/he is in fact at a given stem in a protocol as the systemhas reasoned.

Although one embodiment of the tracking system 195 is described above,it should be understood that the number and types (e.g.,electromagnetic, optical, rF/IR, accelerometers, voice recognition, etc.or combination thereof) of tracking technologies and combinationsthereof to locate positions or movement of resources 105 or moveablecomponents thereon can vary.

The controller 200 can be in wired or wireless communication with one ormore of the medical deliverables 120 or the tracking system 195 so as totrack movement or consumption or disposal of the resources 105 betweenvarious states or locations. The communication of the controller 200with the tracking system 195 can be via a wireless connection (e.g.,radio frequency, etc.) or wired connection (e.g., communication bus,etc.) or combination thereof. Communication can be direct, or over anInternet network or an Ethernet network or a local area network (LAN).

An embodiment of the controller 200 can include a computer in a desktopconfiguration or laptop configuration or central workstation or kiosk orserver or remote workstation. Yet, the type of controller 200 can vary.The controller 200 generally includes one or more processors 270 incommunication with a memory 275 having a computer-readable storagemedium (e.g., compact disc (CD), DVD, memory stick, random access memory(RAM), random operating memory (ROM), etc.). The storage medium isgenerally operable to receive and record a plurality of programmableinstructions for execution by the processor 155.

Referring to FIG. 2, an embodiment of the memory 275 includes a programpackage 300 comprising a plurality of modules of program instructionsdirected to a general structure to manage and direct feedback related toacquired data associated with completion of protocol during delivery ofhealthcare to the patient 110.

Module 305 includes program instructions directed receiving and creatinga protocol template for each process or procedure to perform on thepatient. When creating the protocol template, the module 305 can receiveand store the series of tasks or steps to complete the procedure,milestones or events that demarcate progress from start to end of theprocedure, resources employed in the procedure, and a predicted durationof time to complete one or more tasks or to complete the overallprocedure.

Module 310 includes program instructions directed to creating orreceiving mathematical models or algorithms representative of eventtriggers or temporal relationships or logic operable to reason oridentify occurrence of the activity or step or protocol.

Module 315 includes program instructions directed to tracking,identifying or detecting the presence or movement of multiple resourcesin the space or suite, or the ingress/egress relative to certain createdzones or volumes defined within the space, employing data received fromone or more of the tracking technologies described above.

Module 320 includes program instructions directed to trigger that anevent has taken place or occurred is about to occur. The mathematicalmodels or algorithms can comprise multiple AND/OR statements accordingto detection of movement or presence of various resources in the spaceor suite being monitored with the tracking system.

Module 325 includes program instructions representative of comparatorlogic to track, detect or identify when a milestone event has beenreached or occurred. One embodiment of the comparator logic can includeAND/OR rule-based, evidentiary or artificial intelligence based logic totrigger or equate that the milestone event occurred if the trackingsystem provides data of evidence of the presence or movement of one ormore unique or classifications of resources within the space or othersmaller zone or volume described below. Computer reasoned protocol andactivity steps not passing an adjustable threshold of certainty may beconfigured to trigger and receive clarifying feedback (e.g., verbalinput or output).

Module 330 includes program instructions directed to communicatingfeedback for storage in the memory 275. In one example, images are notstored and the program instructions only direct communication of thecomputer vision renderings and reasoning.

Referring back to FIG. 1, an embodiment of the controller 200 is alsoconnected in communication with an input device 350 and an output device355. The input device 350 can include one or combination of a keyboard,touch-screen, remote computer workstation, mouse, joystick, trackerball, etc. or the like operable to receive data from an operator. Theoutput device 355 can include a display comprising one or combination ofa monitor, an alarm, light emitting diodes (LEDs), printer, audiblespeaker, pager, personal data assistant (PDA), etc. operable to visuallyor audibly show an output of the controller 200 for illustration to anoperator. The controller 200 can also be connected in communication witha remote computer or workstation (not shown).

The system 100 can also be connected in communication with miscellaneousother resources 105, including health information systems (HIS).

FIG. 3 includes a flow diagram to illustrate an embodiment of a method400 of operation of the system 100 to manage workflow in a surgicalsuite. It should also be understood that the sequence of the acts orsteps of the method 400 as discussed in the foregoing description canvary. Also, it should be understood that the method 400 may not requireeach act or step in the foregoing description, or may include additionalacts or steps not disclosed herein. It should also be understood thatone or more of the steps of the method 400 can be represented ascomputer-readable program instructions for execution by one or moreprocessors 270 of the controller 200.

Assume the method 400 can be directed to the surgeon and staff 115delivering a peri-operative procedure to the patient 110 on the table130. Also assume that the delivery of healthcare can be defined into asuccession of tasks or steps of a protocol. The succession of stepscomprising the protocol can be stored in a template 405 located in adatabase 410 of the memory 275. The operator can update the list ofresources 105 and tasks to perform the protocol of the procedure via theprotocol template 405 stored in the database 410 at any time. One ormore of the steps or tasks can be associated with ingress or egress ofone or more resources 105 into the control volume 210 or sterile zone215. Also, one or more of the steps of the protocol can be performedoutside the control volume 210 or sterile zone 215. Each step or task ofthe protocol can be associated with a predicted time duration tocomplete, that together with all of the steps comprise a total predictedtime duration to complete the protocol to deliver healthcare to thepatient 110. The protocol may further include tasks or steps to complete(e.g., deliverables or room preparation, cleanup, transfer of dirtyequipment to be cleaned or introduction of clean equipment to the space,etc.) even though the patient 110 may not present in a space 412 (e.g.,surgical suite). Also assume that protocol includes multiple events ormilestones from start to completion. One or more of the events ormilestones can be associated with detection or identification ofmultiple tasks or detection of resources associated therewith orcombination thereof. The following discussion of an example can explainin more detail.

Step 420 can include detecting or tracking the location of the patient110 in the control zone 210 or at the table 130. The location of thepatient 110 can be detected via the tracking system 195 employing one ormore of the technologies (e.g., RFID, IR technology, electromagnetictransmitters, motion detectors, (e.g., at the table), voice recognition,etc.) or a combination thereof described above. Step 420 can includeoutputting a signal representative of a milestone 422 of protocolexecution as well as that of confirming location of the patient 110 inthe control volume 210 or placement on the table 130.

Step 430 can include detecting the delivery of anesthesia to the patient110. Step 430 can include acquiring a communication signal of such fromthe anesthesia machine 135, or acquiring a voice recognition of aninstruction of delivery of anesthesia to the patient 110, comparison ofa biometric measurement (e.g., respiratory rate or heart monitor of thepatient 110) relative to a threshold indicative of sedation, etc. Step430 can include outputting a signal representative of a milestone 432 ofexecution of sedation of the patient 110.

Step 435 can include tracking removal of sterile or non-sterileresources 105 and 145 and no reentry thereof of contaminated resources105 into the control volume 210.

Step 435 can include tracking of staff 115 within a threshold distanceof and for a threshold time relative to a hand hygiene system 436 priorto detection of entry of the staff 115 into the control volume 210employing one or combination of the technologies of the tracking system195 described above. Step 435 can include comparing a predicted duration(see 437 in FIG. 4) to verify removal of non-sterile items to an actualmeasurement of duration (see 438 in FIG. 4) to verify sterility of thecontrol volume 210.

Step 440 can include detecting preparation of the surgical site 192(e.g., shaving/scrubbing/application of disinfectant) on the patient110. An embodiment of step 440 can include detection via signalsacquired from the tracking system 195 (e.g., the optical technology 230,the RFID/IR technology 250, the electromagnetic technology 220, thevoice recognition technology 260, etc.) indicative or representative ofthe staff 115 within a threshold distance of the patient 110 or table130 or within the control volume 210 as defined by the tracking system195. Step 440 can also include acquiring signals from the voicerecognition technology or system 260 representative of key wordsexpressed by the staff 115 indicating application or execution ofshaving/scrubbing/application of disinfectant at the surgical site 192of the patient 110.

Step 445 can include calculation and outputting a signal representativeof the milestone 446 for completion of prep of the patient 110. Anembodiment of step 445 can include comparison of the detected steps ortasks described above relative to the protocol to identificationcompletion of the event or milestone 446 of prep of the patient 110 toreceive delivery of healthcare (e.g., the surgical procedure). Althoughthe event or milestone 446 of prep of the patient 110 is described withcompletion of one or more of the tasks or steps described above, itshould be understood that the number and types of steps to associatewith this or other milestones can vary in combination or includedifferent steps than that described.

Step 450 can include detection of placement of the drape 190 over thepatient 110. Step 450 can be performed upon visualization of theauthorization of milestone of the prep of the patient 110 in step 445.Step 450 can include detecting entry of the drape 190 into the sterilezone 215 via one or combination of the tracking technologies describedabove for placement of the drape 190 over the surgical site 192 of thepatient 110.

Step 455 can include detecting and outputting a signal representative ofa milestone 456 for defining or establishing the sterile zone 215 overor around the surgical site 192 on the patient 110. An embodiment of thesterile zone 215 can be a three-dimensional portion of the controlvolume 210 or a two-dimensional plane. Outputting the signalrepresentative of the milestone 456 can be in response to calculatingaccording to an AND logic function representative of acquiring signalsrepresentative of completion or detection of more than one of followingevents: the milestone 446 for prep of the patient 110, placement of thesurgical drape 190, and establishing the control volume 210.

Step 460 can include detecting or calculating and outputting a signalrepresentative of the milestone 462 of verification of the staff 115(e.g., surgeon, nurse, technician, etc.) to perform the procedure havinga sterile state and positioned in the control volume 210 and/orpositioned ready to perform the procedure. Detection of the sterilestate of the staff 115 can be performed with tracking (e.g., optical,RFID, IR, electromagnetic, etc.) of the staff 115 to be present for athreshold time within a predetermined threshold distance of the handhygiene or sterilization station 436 (See FIG. 1).

Step 465 can include dynamic tracking of the control volume 210 todetect presence of predetermined resources 105 each having a sterilestate (as determined per RFID tracking of sterilization of each resource105 relative to a cleaning station (e.g., detection of location in acleaning room for a threshold time or within threshold distance of handhygiene station 436 for threshold time) located therein to perform theprocedure per the according to the predetermined list of resources 105stored in the template 405 associated with the procedure and stored inthe database 410 at the memory 275. Step 465 can include comparing oneor more of the tracking technologies of the tracking system 195described above to verify the identify of the resources 105 in thecontrol volume 210.

Step 465 can include a technique referred to “counting out”, where thesystem 100 detects and outputs a list 466 (See FIG. 4) of resources 105(e.g., miscellaneous tools such as sponges, catheters, scalpels, etc.)that enter the sterile zone 215 counting out a list 467 (See FIG. 4) ofresources 105 leaving the sterile zone 215. Step 465 further includestracking to detect and alarm if entry of any non-sterile resources intothe control volume 210 or the sterile zone 215, or if the list 467 ofresources 105 leaving the sterile zone 215 does not equate to the list466 of resources 105 that enter the sterile zone 215.

Step 465 can further include calculating and outputting a probability468 of ingress or egress of one or more resources 105 to or from thesterile zone or control volume. The probability 468 can be calculateddependent in a predetermined manner or algorithm (e.g., linearrelationship, logarithmic relationship, exponential, weighted accordingto predetermined factors assigned to tracking technologies, otherparametric relationship, etc.) according to a number of and type (e.g.,RFID/IR system 250 may be more reliant on detection than optical system230) of technologies operable to track movement of the resource 105. Theprobability 468 can also increase in a manner described above withdetection via voice recognition of reference of the resource 105relative to point in time of ingress or egress to the control volume 210or sterile zone 215, and relative to identification of the resources 105in the list as stored in the protocol template 405 to perform theidentified task occurring or for the overall procedure or process todeliver healthcare to the patient 110.

Step 470 can include employing one or combination of the trackingtechnologies (e.g., electromagnetic tracking system 220, opticaltracking system 230, voice recognition system 260, GPS tracking system225, RFID/IR system 250, etc.) of the tracking system 195 to identifyand output signals representative of completion of miscellaneouspredetermined tasks or milestones of the procedure or process towardcompletion, as listed or described in the protocol template 405.

Step 475 can include detecting and outputting the milestone 476 of readyor start to close the surgical site 192 of the patient 110. Step 475 caninclude calculating the milestone 476 to equate to an AND logic functionof receiving authorization of completion of step 465 and acquiringsignals representative of completion of the tasks of the procedure asdescribed in step 470.

Step 480 can include outputting a dashboard 500 (See FIG. 4) including atemporal display of a predicted time and a measured time to reach eachmilestone in the procedure described above for illustration at theoutput device 355 (See FIG. 1). This step 480 can occur continuouslyfrom prior to start of the procedure to conclusion of the procedure,providing updates to a central or remote workstation of changes inpredicted durations to deliver healthcare to patients 110, changes topredicted time to complete, and to display alerts to impact of updatedduration of time of use of resources 105 and later cleanup relative tosubsequent scheduling of the resources 105 for use in delivery ofhealthcare on other patients 110.

FIG. 4 shows an embodiment of the output of data from the system 100 forillustration in the dashboard 500 in managing the delivery of healthcareto the patient 110. The dashboard 500 can include graphicrepresentations of one or more of the milestones or events or tasks ofthe method 300 described above, including: milestone 422 for entry ofpatient into the space, milestone 432 for sedation of patient 110,milestone 446 for prep of the patient 110, defining the control volume210, milestone 456 for creating sterile plane or zone 215, milestone 462for positioning of staff 115 ready (e.g., sterile) to perform procedure,step of counting out resources 105 employed in performing the procedureon or delivery of healthcare to the patient 110, milestone 476 of readyto close of surgical site 192 on patient 110, predicted duration of time437 between each milestone event, measured or actual time 438 betweeneach milestone event, list 505 of ingress or egress of resources 105 toor from the control volume 210, list 466, 467 of ingress or egress ofresources 105 detected to or from the sterile zone 215, and graphicillustrations of an interdependency 520 of resources 105 to theirforward or later or subsequent schedule of use or location orcombination thereof in performance of procedures on other patients 110.It should be understood that the type and number of graphicrepresentations comprising the dashboard 500 can vary.

An example of a technique to identify interdependencies in thescheduling of resources 105 is described in U.S. patent application Ser.No. 112/040,646 to Johnson et al, entitled “Method To View ScheduleInterdependencies and Provide Proactive Clinical Process DecisionSupport in Day View Form”, filed on Feb. 29, 2008 and herebyincorporated herein by reference in its entirety. Visualization ofinterdependency 520 in the scheduling or predicted or actual timedevents 437, 438 or milestones 422, 432, 456 of performance of theresources 105 (see FIG. 1) can be illustrated as a critical path (seedashed line and reference 525). Tasks and the resources 105 (e.g.,people, equipment, consumables, medications, disposables, etc.) toperform the tasks in accordance to the protocol can be predetermined andlisted in association with template 405 (See FIG. 1) so as directscheduling of the resources 105 prior to delivery of care to the patient110. The dashboard 500 can generally illustrate how the system 100 mapsthe precedence of tasks to perform the protocol relative to a time scale(see dashed line and reference 530) in the scheduling of the resources105 to deliver healthcare to multiple patient 110 over an extendedperiod (e.g., day) in association with predictions of the durations oftasks to be completed with the resources 105. Forecast scheduling ofresources 105 and predicted durations of tasks 437 can be updatedmanually or statistically over time with enabling the providers of careto become aware of where delays and variances occur.

The dashboard 500 can further include a comparison of tracking of actualcompletion of events 438 or milestones 422, 432, 456 relative to list oftasks or milestones as described in protocol template 405, actual ormeasured time of occurrence or duration 438 of events or tasks relativeto the prediction 437 of time or duration of events or tasks, or acomparison of the tracking of spatial distribution of resources 105 anddefined control volume 210 or sterile zone 215 (see FIG. 1) relative toa predicted spatial distribution thereof according to data acquired bythe tracking system 195 in comparison to predetermined spatialdistribution as described or stored in the protocol template 405.

The system 100 and method 400 can employ multiple tracking technologies,mathematical modeling techniques, and comparative logic rules to outputthe visualization for illustration. Another technical effect of thesystem 100 and method 400 can include tracking and comparing thepredetermined protocol standard relative to actual events of protocol,time of events of protocol, and standard versus spatial distribution ofresources 105 and output feedback of comparison for illustration.Another technical of the system 100 and method 400 can include providingthe above-described technical effects of tracking and comparing inlow-intrusive or low-interruptive manner that minimally interferes withthe performance of the resources 105 executing the protocol.

One or more elements or constructions of one or more embodiments of thesubject matter described above may be combined with one or more elementsor constructions of other embodiments of the subject matter describedabove and is not limiting on the subject matter described herein.

A technical effect of the subject matter described herein can includeproviding the system 100 and method 400 and dashboard 500 to visualizelocation and scheduling of the resources 105 (e.g., assets, people,consumables, apparatus and etc.) in the delivery of healthcare topatients. The system 100 and method 200 and dashboard 500 can identifyof problems (e.g., delays, missed protocol, etc.) and theinterdependence, status and relationship of the resources 105 to theexecution of protocol scheduled in the future delivery of the healthcareto patients 110.

Another technical effect can include providing the system 100 and method200 output proposed actionable decisions or to automatically triggeractionable decisions in scheduling or execution of protocol in responseto the detection of problems in the delivery of healthcare to patients.This technical effect can be realized with visualization of theinterdependencies of the resources 105 in the past, present and future,as well as visualization of the past, present and scheduled or predictedfuture status (e.g., locations, scheduled cleaning, scheduled breaks,scheduled unavailability of staff, etc.) of the resources 105 so as tosimulate and visualization of potential or predicted scenarios in thescheduling of resources 105. For example, the system 100 or method 200can simulate of the scheduling and execution of protocol by theresources 105 so as to allow care providers to scroll forward to uncoverpotential bottlenecks in the future schedule and to receive list ofalternative action options (e.g., list of alternate available resources105 and locations). The system 100 and method 200 can also calculate oroutput a confidence or probability in the simulation of the schedule ofresources 105. An embodiment of the system 100 and method 200 canfurther output alerts to problems (e.g., delays, low confidence, etc.)and interdependencies of scheduled resources 105 upon comparison toacceptable or unacceptable thresholds of variation.

This written description uses examples to disclose the invention,including the best mode, and also to enable any person skilled in theart to make and use the invention. The patentable scope of the inventionis defined by the claims, and may include other examples that occur tothose skilled in the art. Such other examples are intended to be withinthe scope of the claims if they have structural elements that do notdiffer from the literal language of the claims, or if they includeequivalent structural elements with insubstantial differences from theliteral languages of the claims.

We claim:
 1. A method of managing delivery of healthcare via a pluralityof resources to a patient, the method comprising the steps of: trackingand outputting a signal representative of a location of at least one ofthe plurality of resources relative to a control volume associated withthe patient; acquiring at least one signal representative of detectingingress or egress of at least one of the plurality of resources relativeto the control volume; and outputting a first signal representative ofone of a plurality of milestones as defined in a predetermined protocolin response to detecting ingress or egress of at least one of theplurality of resources relative to the control volume.
 2. The method ofclaim 1, wherein the step of tracking includes outputting at least onesignal representative of an ingress or an egress of at least oneresource relative to a sterile zone within the control volume.
 3. Themethod of claim 1, wherein the step of tracking is performed by morethan one of the following: an optical tracking system, anelectromagnetic tracking system, an RFID tracking system, an IR trackingsystem, a GPS tracking system, and a voice recognition system, andwherein the step of tracking includes outputting at least one signalrepresentative of ingress or egress of one of the plurality of resourcesrelative to a sterile zone located within the control volume.
 4. Themethod of claim 3, further comprising the steps of outputting aprobability of ingress or egress of at least one of the plurality ofresources relative to the sterile zone, the probability dependent on howmany of or which of the different tracking systems detects ingress oregress of the at least one of the plurality of resources relative to thesterile zone.
 5. The method of claim 4, wherein the step of outputtingthe probability is dependent on a mathematical expression having a firstfactor associated with detecting ingress or egress of the at least oneof the plurality of resources relative to the sterile zone with a firsttracking system and a second factor associated with detecting ingress oregress of the at least one of the plurality of resources relative to thesterile zone with a second tracking system different than the firsttracking system.
 6. The method of claim 3, further comprising the stepsof: outputting a comparison of ingress of at least one of the pluralityresources to a sterile zone defined within the control volume relativeto egress of at least one of the plurality of resources from the sterilezone, the ingress and egress as detected by one of the tracking systems.7. The method of claim 1, further comprising the steps of: outputting asecond signal representative of another of the plurality of milestonesas defined in a predetermined protocol in response to the step ofoutputting the first signal; in combination with one of the followingsteps: detecting ingress or egress of another of the plurality ofresources relative to the control volume, and detecting a key text in atranslation of an audio recording where the key text is associated withexecuting the another of the plurality of milestones and predeterminedin a protocol template for storage in a database.
 8. The method of claim1, further comprising the step of: outputting a comparison of apredicted time for the milestone to occur relative to a measured time ofoccurrence of outputting the first signal representative of themilestone.
 9. The method of claim 1, wherein the milestone isrepresentative of one of the following: prep of the patient to receive amedical procedure, sedation of the patient to receive the medicalprocedure, and close of the surgical site on the patient.
 10. A systemto manage delivery of healthcare via a plurality of resources to apatient, the system comprising: at least one tracking system operable togenerate a signal representative of a location of at least one of theplurality of resources relative to a control volume associated with thepatient; and a controller in communication with the tracking system, thecontroller including a processor in communication with a memory, theprocessor operable to execute a plurality of program instructions storedin the memory, the plurality of program instructions representative ofthe steps of: acquiring at least one signal representative of detectingingress or egress of at least one of the plurality of resources relativeto the control volume; outputting a first signal representative of oneof a plurality of milestones as defined in a predetermined protocol inresponse to detecting ingress or egress of at least one of the pluralityof resources relative to the control volume.
 11. The system of claim 10,wherein the tracking system comprises more than one of the following: anoptic tracking system, an electromagnetic tracking system, an RFIDtracking system, an IR tracking system, a GPS tracking system, and avoice recognition system, and wherein the tracking system generates atleast one signal representative of ingress or egress of one of theplurality of resources relative to a sterile zone located within thecontrol volume.
 12. The system of claim 11, further comprising programinstructions representative of the step of calculating a probability ofingress or egress of at least one of the plurality of resources relativeto the sterile zone, the probability dependent on how many of or whichof the different tracking systems detects ingress or egress of the atleast one of the plurality of resources relative to the sterile zone.13. The system of claim 12, wherein outputting the probability isdependent on a mathematical expression having a first factor associatedwith detecting ingress or egress of the at least one of the plurality ofresources relative to the sterile zone with a first tracking system anda second factor associated with detecting ingress or egress of the atleast one of the plurality of resources relative to the sterile zonewith a second tracking system different than the first tracking system.14. The system of claim 10, wherein the further comprising programinstructions representative of the steps of: outputting a comparison ofingress of at least one of the plurality resources to a sterile zonedefined within the control volume relative to egress of at least one ofthe plurality of resources from the sterile zone, the ingress and egressas detected by the tracking system.
 15. The system of claim 10, furthercomprising outputting a second signal representative of another of theplurality of milestones as defined in a predetermined protocol inresponse to the step of outputting the first signal, and in combinationwith at least one of the following: detecting ingress or egress ofanother of the plurality of resources relative to the control volume,and detecting a key text in a translation of an audio recording wherethe key text is associated with executing the another of the pluralityof milestones and predetermined in a protocol template for storage in adatabase.
 16. The system of claim 10, further comprising programinstructions representative of the steps of outputting a comparison of apredicted time for the milestone to occur relative to a measured time ofoccurrence of outputting the first signal representative of themilestone.
 17. The system of claim 10, further comprising an programinstructions representative of: calculating a variation between adifference in a predicted schedule of time of use of the resource and anactual time of use of the resource relative to a threshold; andoutputting an interdependency of the scheduled time of use of theresource for the patient relative to another scheduled time of use ofthe resource for another patient in response to calculating thevariation exceeds the threshold.
 18. The system of claim 10, wherein themilestone is representative of one of the following: prep of the patientto receive a medical procedure, establishment of a sterile field,sedation of the patient to receive the medical procedure, and close of asurgical site on the patient.